Articles: neuralgia.
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Randomized Controlled Trial
The Effect of Erector Spinae Plane Blockade on Prevention of Postherpetic Neuralgia in Elderly Patients: A Randomized Double-blind Placebo-controlled Trial.
Postherpetic neuralgia (PHN) is the most common chronic complication following the onset of herpes zoster (HZ). Both the incidence of HZ and the proportion of patients with HZ who develop PHN rise with age. Ultrasound-guided erector spinae plane blockade (ESPB) has been reported to relieve neuropathic pain and PHN in elderly patients, but no randomized controlled trials have been conducted regarding the effect of ESPB on elderly patients with HZ in the acute or subacute phases. ⋯ For elderly patients suffering acute or subacute HZ, ESPB reduces the incidence of PHN at 12 weeks after treatment; it also decreases the occurrence of neuropathic pain, sleep disturbance, and anxiety/depression.
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Reg Anesth Pain Med · Nov 2021
Protein kinase G signaling pathway is involved in sympathetically maintained pain by modulating ATP-sensitive potassium channels.
Sympathetically maintained pain (SMP) involves an increased excitability of dorsal root ganglion (DRG) neurons to sympathetic nerve stimulation and circulating norepinephrine. The current treatment of SMP has limited efficacy, and hence more mechanistic insights into this intractable pain condition are urgently needed. ⋯ Our findings suggest an important role of cGMP-PKG signaling pathway in the increased excitability of small-diameter DRG neurons to norepinephrine after CTT, which involves an inhibition of the ATP-sensitive potassium currents through PKG-induced phosphorylation. Accordingly, drugs targeting this pathway may help to treat SMP.
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Patients with chronic neuropathic pain (NP) have a significantly increased risk of central nervous degeneration. Trigeminal neuralgia (TN) is a typical NP, and this manifestation is more obvious. In addition to severe pain, patients with TN are often accompanied by cognitive dysfunction and have a higher risk of central nervous system degeneration, but the mechanism is not clear. ⋯ Interestingly, NLRP3 specific blocker MCC950 can alleviate the neurodegeneration of trigeminal neuralgia rats to a certain extent. It is suggested that our NLRP3 inflammasome plays an important role in the neurodegeneration of trigeminal neuralgia rats. And it is related to the activation of central nervous system inflammation.
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Randomized Controlled Trial
Prediction of Individual Analgesic Response to Intravenous Lidocaine in Painful Diabetic Peripheral Neuropathy: A Randomized, Placebo-controlled, Cross-over Trial.
Intravenous lidocaine can alleviate painful diabetic peripheral neuropathy (DPN) in some patients. Whether quantitative sensory testing (QST) can identify treatment responders has not been prospectively tested. ⋯ While some participants reported therapeutic benefit from lidocaine administration, QST measures alone were not predictive of response to treatment. Further studies, powered to test more complex phenotypic interactions, are required to identify reliable predictors of response to pharmacotherapy in patients with DPN.